Diagnostic efficacy of prostate cancer using targeted biopsy with 6-core systematic biopsy for patients with PI-RADS 5.
- Author:
Yi LIU
1
,
2
,
3
;
Chang Wei YUAN
1
,
2
,
3
;
Jing Yun WU
4
;
Qi SHEN
1
,
2
,
3
;
Jiang Xi XIAO
4
;
Zheng ZHAO
1
,
2
,
3
;
Xiao Ying WANG
4
;
Xue Song LI
1
,
2
,
3
;
Zhi Song HE
1
,
2
,
3
;
Li Qun ZHOU
1
,
2
,
3
Author Information
1. Department of Urology, Peking University First Hospital
2. Institute of Urology, Peking University
3. National Urological Cancer Center, Beijing 100034, China.
4. Department of Radiology, Peking University First Hospital, Beijing 100034, China.
- Publication Type:Journal Article
- Keywords:
Biopsy;
Magnetic resonance imaging;
Prostate imaging reporting and data system;
Prostatic neoplasms
- MeSH:
Male;
Humans;
Prostatic Neoplasms/pathology*;
Magnetic Resonance Imaging/methods*;
Retrospective Studies;
Prostate/diagnostic imaging*;
Image-Guided Biopsy/methods*
- From:
Journal of Peking University(Health Sciences)
2023;55(5):812-817
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the diagnostic efficacy of targeted biopsy (TBx), systematic biopsy (SBx), TBx+6-core SBx in prostate cancer (PCa) / clinically significant prostate cancer (cs-PCa) for patients with prostate imaging reporting and data system (PI-RADS) score of 5, and thereby to explore an optimal sampling scheme.
METHODS:The data of 585 patients who underwent multiparametric magnetic resonance imaging (mpMRI) with at least one lesion of PI-RADS score 5 at Peking University First Hospital from January 2019 to June 2022 were retrospectively analyzed. All patients underwent mpMRI / transrectal ultrasound (TRUS) cognitive guided biopsy (TBx+SBx). With the pathological results of combined biopsy as the gold standard, we compared the diagnostic efficacy of TBx only, SBx only, and TBx+6-core SBx for PCa/csPCa. The patients were grouped according to mpMRI T-stage (cT2, cT3, cT4) and the detection rates of different biopsy schemes for PCa/csPCa were compared using Cochran's Q and McNemar tests.
RESULTS:Among 585 patients with a PI-RADS score of 5, 560 (95.7%) were positive and 25(4.3%) were negative via TBx+SBx. After stratified according to mpMRI T-stage, 233 patients (39.8%) were found in cT2 stage, 214 patients (36.6%) in cT3 stage, and 138 patients (23.6%) in cT4 stage. There was no statistically significant difference in the detection rate of PCa/csPCa between TBx+6-core SBx and TBx+SBx (all P>0.999). Also, there was no statistically significant difference in the detection rate of PCa/csPCa between TBx and TBx+SBx in the cT2, cT3, and cT4 subgroups (PCa: P=0.203, P=0.250, P>0.999; csPCa: P=0.700, P=0.250, P>0.999). The missed diagnosis rate of SBx for PCa and csPCa was 2.1% (12/560) and 1.8% (10/549), and that of TBx for PCa and csPCa was 1.8% (10/560) and 1.4% (8/549), respectively. However, the detection rate of TBx+6-core SBx for PCa and csPCa was 100%. Compared with TBx+SBx, TBx and TBx+6-core SBx had a fewer number of cores and a higher detection rate per core (P < 0.001).
CONCLUSION:For patients with a PI-RADS score of 5, TBx and TBx+6-core SBx showed the same PCa/csPCa detection rates and a high detection rates per core as that of TBx+SBx, which can be considered as an optimal scheme for prostate biopsy.
